Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with metabolic and reproductive dysfunction. Emerging evidence suggests a significant association between PCOS and thyroid autoimmunity, especially elevated anti-thyroid peroxidase (anti-TPO) antibodies. This study aimed to assess anti-TPO antibody levels in women with PCOS and evaluate their clinical, biochemical, and ultrasonographic profile.

Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at a tertiary care hospital, Jaipur, Rajasthan over 18 months. A total of 73 women aged 13–45 years were enrolled: 66 PCOS patients diagnosed using Rotterdam criteria and 7 healthy controls. Detailed history, clinical examination, anthropometry, ultrasonography, and laboratory investigations (serum TSH, free T3, free T4, fasting blood sugar, anti-TPO antibodies, and free testosterone) were performed. Data were analyzed using appropriate statistical methods; p<0.05 was considered significant.

Results: Majority of the PCOS patients were aged 21–25 years (37.9%). PCOS patients had significantly higher weight, BMI, and waist–hip ratio compared to controls (p=0.001). Hyperandrogenism was present in 50% of PCOS patients, and oligomenorrhoea/amenorrhoea in 97%. Serum free testosterone was significantly elevated in PCOS (3.58±1.67 vs. 1.94; p=0.012). Anti-TPO antibody levels were markedly higher in PCOS patients (81.36±45.67 IU/mL) than controls (19.90 IU/mL; p=0.001). Free T3 was also significantly higher in PCOS (p=0.020), while TSH and free T4 were comparable between groups. Ultrasonography showed increased follicle number and significantly higher ovarian volume in PCOS patients (p=0.001).

Conclusion: PCOS is associated with significant metabolic, hormonal, and ultrasonographic abnormalities and a higher prevalence of thyroid autoimmunity. Routine anti-TPO antibody screening in PCOS patients is recommended for early detection and improved clinical management.

KEYWORDS: Polycystic Ovary Syndrome, Anti-thyroid Peroxidase Antibodies, Thyroid Autoimmunity, Hyperandrogenism, Oligomenorrhoea.